Laryngoscope With Handle-Grip Activated Recording

ABSTRACT

Disclosed are embodiments of a laryngoscope that facilitates targeted recording (video, or audio, or both video and audio) of time intervals associated with active laryngoscopy. In accordance with the teachings of the disclosure, a characteristic that reliably defines the interval of active laryngoscopy is used to trigger recording. One such characteristic is that the operator&#39;s hand is gripping the handle of the laryngoscope. Accordingly, preferred embodiments implement a laryngoscope having a handle so designed that when the handle is gripped by the operator&#39;s hand, recording is initiated and continued for as long as the operator&#39;s hand maintains a grip on the laryngoscope handle.

CROSS REFERENCE TO RELATED APPLICATIONS

This patent application is a continuation of U.S. application Ser. No.16/409,301, filed May 10, 2019, which is a continuation of U.S.application Ser. No. 15/423,453, filed Feb. 2, 2017, now issued as U.S.Pat. No. 10,299,668, which claims the benefit of and priority to U.S.Provisional Patent Application Ser. No. 62/290,220 filed on Feb. 2,2016, entitled “Laryngoscope With Handle-Grip Activated Video/AudioRecording,” the benefit of and priority to U.S. Provisional PatentApplication Ser. No. 62/449,922 filed on Jan. 24, 2017, entitled“Laryngoscope With Changeable Blade Shape And Size,” and the benefit ofand priority to U.S. Provisional Patent Application Ser. No. 62/290,195filed on Feb. 2, 2016, entitled “Carbon Monoxide (CO) EnvironmentalMonitoring on an Emergency Medical Device, Monitor or Defibrillator” thedisclosures of which are all hereby incorporated by reference for allpurposes. The present disclosure is further related to prior-filed U.S.patent application Ser. No. 14/491,669 field on Sep. 19, 2014, entitled“Multi-Function Video System,” and to prior-filed U.S. patentapplication Ser. No. 11/256,275 filed Oct. 21, 2005, entitled“Defibrillator/Monitor System having a Pod with Leads Capable ofWirelessly Communicating,” the disclosures of which are herebyincorporated by reference for all purposes.

TECHNICAL FIELD

The disclosed subject matter pertains generally to the area of medicaldevices, and more specifically to the area of video laryngoscopy.

BACKGROUND INFORMATION

Many medical instruments rely on the skill of the caregiver for properuse. To enhance those skills, some medical instruments may be providedwith one or more features that give the caregiver more feedback on howwell the caregiver is using the medical instrument. One feedback featurethat has been popularized with laryngoscopes—a tubular endoscopeinserted into the larynx through the mouth to observe the interior ofthe larynx—is a video camera which allows a caregiver to see and capturean image during the procedure. These video laryngoscopes as they arecalled are specialized laryngoscopes that provide real-time video of theairway anatomy captured by a small video camera on the blade insertedinto the airway. They provide a video image on a small screen on thelaryngoscope device, or on the screen of a device that is connected tothe laryngoscope device.

Video laryngoscopes are particularly useful for intubating “difficultairways.” Although video laryngoscopes can be costly to purchase anduse; they may speed up the time to successful intubation by allowing thecaregiver to better see the airway during the intubation process. Videolaryngoscopy is becoming more commonly used to secure an airway in bothhospital and pre-hospital environments.

Laryngoscopy to facilitate endotracheal intubation is one of the mostchallenging critical care procedures widely performed in prehospitalemergency medical care. Some laryngoscopes are designed with a camera orfiber optics on the blade to facilitate enhanced visualization of thetarget structures during laryngoscopy, and some of the videolaryngoscopes allow recording of the video data stream. Such productsrecord the entire data stream from power-on to power- off of the device(or stream that entire interval of data to an accessory recording devicesuch as a computer). However, the data of value comprises only a(potentially very small) portion of the entire recorded data stream. Theexcess data recorded is undesirable because it increases file size andmemory requirements, necessitates more time for data transfer and datareview, and increases the risk of privacy concerns surrounding thecontent of the captured data.

There is a long-felt yet unmet need for improvements in the area ofvideo laryngoscopes.

SUMMARY OF EMBODIMENTS

Embodiments are directed to a laryngoscope that facilitates targetedrecording (video, or audio, or both video and audio) of time intervalsassociated with active laryngoscopy. In accordance with the teachings ofthis disclosure, a characteristic that reliably defines the interval ofactive laryngoscopy is used to trigger recording. One suchcharacteristic is that the operator's hand is gripping the handle of thelaryngoscope. Accordingly, preferred embodiments implement alaryngoscope having a handle so designed that when the handle is grippedby the operator's hand, recording is initiated and continued for as longas the operator's hand maintains a grip on the laryngoscope handle.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a video laryngoscope, according to anillustrative embodiment, in use on a patient.

FIG. 2 is another perspective view of a video laryngoscope, according toan illustrative embodiment.

FIG. 3 is a functional block diagram generally illustrating one possibleexample of components of a laryngoscope according to variousembodiments.

FIG. 4 is a conceptual diagram of electrical signals (e.g., video imagedata) being stored temporarily in a buffer for later storage in anon-volatile memory, in accordance with one embodiment.

FIG. 5 is a conceptual diagram of yet another embodiment of alaryngoscope system in which components may be distributed over two ormore devices, in accordance with the teachings of this disclosure.

DETAILED DESCRIPTION

In describing more fully this disclosure, reference is made to theaccompanying drawings, in which illustrative embodiments of thedisclosure are shown. This disclosure may, however, be embodied in avariety of different forms and should not be construed as so limited.

Generally described, the disclosure is directed to a laryngoscope thatincludes a capture device and a grip sensor. The grip sensor isconfigured to detect that the laryngoscope is being gripped, such as bya medical care giver. In response to detecting that the laryngoscope isbeing gripped, data from the capture device is stored in a non-volatilemanner. Specific embodiments and implementations are described below.

Initial Discussion of Operative Environment

FIG. 1 is a conceptual drawing that depicts an example of a patient 105in whom a laryngoscope 110 is placed to perform a laryngoscopy. Alaryngoscope is a tool used to view a patient's airway anatomy wheninserting an endotracheal tube (not shown). A laryngoscopy is oftenperformed to facilitate tracheal intubation during both elective andemergency airway management procedures in patients meeting indicationsfor definitive airway management such as inability to adequatelyoxygenate or ventilate, inability to maintain airway patency or protectthe airway from aspiration, or anticipation of clinical course. Trachealintubation is the insertion of a breathing tube into the trachea for thepurpose of protecting the airway and facilitating respiratory gasexchange.

The laryngoscope illustratively has a blade 107 attached by someconnector mechanism 114 to a handle 112. The handle allows a caregiverto control the placement of the blade of the laryngoscope into an oralcavity 109 of the patient against the patient's tongue in connectionwith the laryngoscope procedure.

The laryngoscope shown in FIG. 1 is more particularly a videolaryngoscope which includes a video display 120. The video display shownin FIG. 1 is illustrated as integral to the laryngoscope, although itmay alternatively be connected to the laryngoscope either wirelessly orthrough a wired connection (not shown). The video display providesreal-time video of the airway anatomy. Video laryngoscopes are used toimprove visibility of the airway of the patient in order to make thetask of inserting the tube easier and are particularly useful forintubating “difficult airways.”

In the setting of emergency airway management, intubation is usually atime-sensitive procedure, due to risk of physiologic deterioration fromthe prolonged apnea resulting from lengthy intubation attempts, or dueto the risk of interrupting other life-saving interventions such aschest compressions in a cardiac arrest patient or rapid evacuation andtransport of a traumatically injured patient. It is therefore importantto accomplish the laryngoscopy task quickly, preferably, within a singleattempt. Making multiple attempts extends the period without adequategas exchange, and consequent hypercapnia and hypoxia. For this reason,quality assurance measures are desirable to measure, monitor, andprovide feedback on the timing of intubation attempts and the associatedchange in physiological measures (such as pulse oximetry andcapnometry). The video captured by a video laryngoscope provides oneform of enhanced quality assurance and quality improvement measure byproviding video feedback on the procedure as it is performed, and, ifthe video is recorded, allowing detailed video review after theprocedure is over.

Having thus introduced background on laryngoscopy, we now turn tofeatures that are provided by this disclosure.

FIG. 2 is a perspective view of one embodiment of a laryngoscope 200 inaccordance with the disclosure. The laryngoscope 200 includes an imagecapture portion 210 (e.g., a camera), a handle portion 250, and amonitor 225. Internally (so not shown), the laryngoscope 200 of thisembodiment includes a processor, a memory unit, a user interface, and acommunication module. These components are described in detail below inconjunction with FIG. 3. The image capture portion 210 is configured tocapture one or more of a photo images, a video stream of images, or acoded image. Alternatively (or additionally), the image capture portion210 may be configured to capture audio signals in addition to, orperhaps in lieu of, the video image(s).

The image capture portion 210 may include a light source, an imagereflector unit, a window configured for diffusing light, a camerashutter, a scanner shutter, a lens system, light channels, aphotodetector array, and/or a decode module. The photodetector array, inone example, may comprise a photo-sensitive charge coupled device (CCD)array that upon exposure to reflected light when enabled, generates anelectrical pattern corresponding to the reflected light. Alternatively,a laser scanner and a photo-detector may be used to illustrate thatdifferent types of photodetectors besides the charge coupled photosensitive element arrays may be used with this disclosure. As is knownin the art, the light source (or a separate light source) illuminates asubject and the photodetector array converts light reflected from thesubject into corresponding electrical signals. The electrical signalsare in turn rendered on the monitor 225 for viewing by a user.

It should be appreciated that the image capture portion 210 may beimplemented in any appropriate location or even in multiple locations.As illustrated in FIG. 2, the image capture portion 210 is integratedinto the “blade” portion of the laryngoscope, but it could beimplemented elsewhere, such as in the handle 250, or as a component ofan attached extension, such as monitor 225. Still further, the imagecapture portion 210 could be located on a remote wired or wirelesslyconnected component of an electronic monitoring and medical care supportsystem (e.g. a vital signs monitor, a monitor/defibrillator, a tabletdevice used for purposes such as documentation, or a mechanical chestcompression system). Yet even further, more than one image captureportion 210 may be used and implemented in multiple locations.

In this embodiment, the monitor 225 is formed integral (or coupled) tothe handle 250. Alternatively or in addition, the monitor 225 may takethe form of a display that is separate from the handle 250. For example,the separate display may be connected to the laryngoscope 200 by a wiredor wireless connection. Various monitors may be used with embodiments ofthis disclosure, such as an LCD screen, an e-paper (or other bi-stable)display, a CRT display, or any other type of visual display. Oneillustrative embodiment that uses one or more remote monitors isillustrated in FIG. 5 and described below.

The laryngoscope 200 of this particular embodiment further includespower button 216 and a grip sensor 275. The power button 216 operates toactivate the laryngoscope 200 when in use and power on its variouselements, e.g., the image capture portion 210, including its lightsource, and the monitor 225. The grip sensor 275 may be any suitablesensor that can detect that an operator is gripping the handle 250,thereby indicating that the laryngoscope 200 is in active use. The gripsensor 275 may be implemented as a pressure sensor, force sensor,temperature sensor, optical sensor, impedance (e.g., capacitive orresistive) sensor, or the like. Alternatively, the grip sensor 275 couldbe implemented as a tactile or electromechanical switch. In preferredembodiments, when the handle is gripped by the operator's hand (asdetected by the grip sensor 275), recording is initiated and continuedfor as long as the operator's hand maintains a grip on the laryngoscopehandle 250. Although shown in FIG. 2 as a single grip sensor 275,alternative embodiments may employ one or more grip sensors or sensorelements. Multiple grip sensors or sensor elements could be used, forexample, to help differentiate the circumferential grip of a hand versusstray contact with some other object or objects. In addition, noparticular significance should attach to the placement of the gripsensor 275 as shown in FIG. 2. Rather, the placement of the grip sensor275, either on the handle 250 or elsewhere, should be viewed as a designchoice with the purpose of enhancing the determination of an in-use gripby an operator versus stray contact.

In operation, an operator may handle the laryngoscope 200 in preparationfor its use as described above in conjunction with FIG. 1. As part ofpreparing to use the laryngoscope 200, the operator will press the powerbutton 216 to initiate the several systems of the laryngoscope 200,including the image capture portion 210 (in particular it's illuminatinglight source) and, perhaps, the monitor 225. At that point, the imagecapture portion 210 may be actively capturing and rendering imagesand/or video to the monitor 225. As discussed above, it may be desirableto record the images being captured by the image capture portion 210when the laryngoscope 200 is in use. However, and also for the reasonsdiscussed above, it may be undesirable to record all of or even asubstantial portion of the images being captured. Accordingly, while inactive use, an operator engages the laryngoscope 200 by holding thehandle 250 in the area of the one or more grip sensors 275. The gripsensors 275 may passively determine that the laryngoscope 200 is inactive use, such as by merely detecting that the operator's hand is inplace in such a manner that it is likely the laryngoscope 200 is inactive use. Alternatively, the grip sensor 275 may enable the operatorto affirmatively indicate that the laryngoscope 200 is in active use,such as through the use of a tactile switch or the like.

In an embodiment where the image capture portion 210 is located remoteto the handle 210 (e.g., wirelessly connected to a remote electronicmonitoring and medical care support system), the grip sensor 275 andlaryngoscope 200 may cause a signal to be sent to the remote component(not shown) to initiate recording on that remote component.

FIG. 3 is a functional block diagram 810 generally illustratingcomponents of one particular implementation of a laryngoscope 300constructed in accordance with this disclosure. In this embodiment, thelaryngoscope 300 includes a processor 820, a memory unit 830, acommunication module 840, a user interface 850, an image capture module860, an optional audio capture module 870, and a power source 880.

Processor 820 may be implemented in any number of ways. Such waysinclude, by way of example and not of limitation, digital and/or analogprocessors such as microprocessors and digital-signal processors (DSPs);controllers such as microcontrollers; software running in a machine;programmable circuits such as Field Programmable Gate Arrays (FPGAs),Field-Programmable Analog Arrays (FPAAs), Programmable Logic Devices(PLDs), Application Specific Integrated Circuits (ASICs), anycombination of one or more of these, and so on.

Memory unit 830 may be implemented in any number of ways. Such waysinclude, by way of example and not of limitation, volatile memory (e.g.,RAM, etc.), nonvolatile memories (e.g., hard drive, solid state drive,etc.), read-only memories (e.g., CD-ROM, DVD, etc.), or any combinationof these. Memory 830 may include programs containing instructions forexecution by processor 820. The programs provide instructions forexecution by the processor 820, and can also include instructionsregarding protocols and decision making analytics, etc. In addition,memory unit 830 can store rules, configurations, data, etc. Althoughillustrated as being collocated with the other components of thelaryngoscope 300, it should be appreciated that the memory unit 830, oran ancillary memory unit (not shown), could alternatively be located ona remote wired or wirelessly connected component.

Communication module 840 may be implemented as hardware, firmware,software, or any combination thereof, configured to transmit databetween the laryngoscope 300 and other devices. In an illustrativeembodiment, the communication module 840 may include a wireless moduleand/or a hardwire connect module. The wireless module may illustrativelybe a Wi-Fi module. Additionally or alternatively, the wireless modulemay be a Bluetooth module, a cellular communication module (e.g., GSM,CDMA, TDMA, etc.), a Wi-Max module, or any other communication modulethat enables a wireless communication link for the bidirectional flow ofdata between the image capture device and an external device. Thehardwire connect module may be a hardware and software based dataconnector configured to connect with a data outlet of an external devicesuch as a computer. The hardwire connect module may be implemented asone or more ports and associated circuitry and software that allowbidirectional flow of data between the laryngoscope 300 and otherdevices. Illustratively, the hardwire connect module may be an Ethernetconnector, an RS232 connector, a USB connector, an HDMI connector, orany other wired connector. The communication module 840 is capable ofenabling transmission of data captured using the image capture module860 to other devices.

The image capture module 860 is hardware and software configured toprovide the optical functionality required for the capture of photoimage, a video stream of images, or a coded image. Examples of the imagecapture module 860 may include a complementary metal-oxide semiconductor(CMOS), N-type metal-oxide semiconductor (NMOS), a charge coupled device(CCD), an active-pixel sensor (APS), or the like. The image capturemodule 860 may additionally include video processing software, such as acompression/decompression module, and other components, such as ananalog-to-digital converter. The image capture module 860 still furtherincludes a light source (not shown) which is used to illuminate thesubject area under view. Still further, the image capture module 860could be implemented with additional features, such as a zooming and/orpanning capability.

Although only a single image capture module 860 is shown in FIG. 3, itshould be appreciated that more than one image capture module 860 couldbe implemented within the laryngoscope 300 or distributed among thelaryngoscope 300 and other medical devices with which the laryngoscope300 is in communication. For example, the laryngoscope 300 could haveone image capture module 860 integral to the laryngoscope 300 and alsobe in active communication with an attachment or extension that includesa second image capture module 860.

An optional audio capture module 870 may also be included for capturingaudio signals. In such an embodiment, the optional audio capture module870 may include a microphone or other audio signal capture hardware(e.g., an analog-to- digital converter, etc.), and may also includeaudio processing software, such as a compression/decompression module,or the like.

The image capture module 860 and the optional audio capture module 870could either or both be located somewhere in the body of thelaryngoscope 200 (e.g., the handle, the blade, or a directly-attachedextension to the laryngoscope 200, such as the monitor). Alternately orin addition, the image capture module 860 and the optional audio capturemodule 870 could either or both be located on a remote wired orwirelessly connected component of an electronic monitoring and medicalcare support system (e.g. a vital signs monitor, amonitor/defibrillator, a tablet device used for purposes such asdocumentation, or a mechanical chest compression system).

Power source 880 is a component that provides power to the severalcomponents of the laryngoscope 300. Power source 880 may be a battery,an externally provided power source, or a combination of both.

User interface 850 is hardware and software configured to enable anoperator to interact with and control the several components of thelaryngoscope 300, such as the processor 820, the memory unit 830, theimage capture module 860, the communication module 840, and the optionalaudio capture module 870. The user interface may include a keypad 852(either physical or virtual), a monitor 854, a power button 856 forturning on the laryngoscope 300, and a grip sensor 858 for initiatingthe capture of a media stream (e.g., images, video, audio, or anycombination thereof). For example, user interface 850 may include amonitor 854 to display a series of instructions and a touch screenkeyboard for the operator to enter data to configure the laryngoscope300 for a particular operation.

For example, the monitor 854 may initially show a home screen with anactivate virtual button to activate the capture of image data. Onpressing the activate button, the monitor 854 may display a menu ofinstructions to navigate the operator to configure the laryngoscope 300to the desired settings. Alternatively, the menu may pop upautomatically on the screen of the display when the power button 856 ispressed.

User interface 850 may also include a speaker (not shown), to issuevoice prompts, etc. User interface 850 may additionally include variousother controls, such as pushbuttons, keyboards, switches, and so on, forpurposes not relevant to the present disclosure.

In operation, and as discussed above, an operator may press (orotherwise trigger) the power button 856 to power on the severalcomponents of the laryngoscope 300, including the image capture module860 (and, in particular, its illuminating light source), the processor820, and the memory unit 830. In this way, the laryngoscope 300 isoperative to begin capturing images from the image capture module 860.Additionally or alternatively, the laryngoscope 300 may also beoperative to begin capturing audio from the optional audio capturemodule 870.

As discussed above, upon detection of the operator's grip upon the gripsensor 880, the processor 820 causes data from the image capture module860 (and/or the audio capture module 870) to be recorded by the memory830. Conversely, when the grip sensor 880 no longer detects the presenceof the operator's grip, the processor 820 causes the data from the imagecapture module 860 (and/or the audio capture module 870) to cease beingrecorded, although the image capture module 860 may continue to streamimages.

In addition, in embodiments that implement communication between thelaryngoscope 300 and other devices, such as via the communication module840, various functions and features may be distributed or duplicated atthose other devices. Turning briefly to FIG. 5, an illustrativeenvironment is shown in which a laryngoscope 599 in accordance with theteachings of this disclosure, is deployed. In this illustrativeembodiment, the laryngoscope 599 includes wireless and/or wiredcommunication to other devices. For example, the laryngoscope 599 ofthis embodiment may be in communication with one or more of amonitor/defibrillator 572, an EMS tablet 526, a handheld device 530,and/or a head-worn display device 531. The laryngoscope 599 mayadditionally be in communication with remote services, such as a remotehospital computer 528 and/or an online tracking system 501. In otherembodiments, the laryngoscope 599 may be implemented as a component orpod of a modular external defibrillator system such as disclosed inaforementioned U.S. patent application Ser. No. 11/256,275“Defibrillator/Monitor System having a Pod with Leads Capable ofWirelessly Communicating.”

It will be appreciated that the laryngoscope 599 of this embodiment maybe in direct communication (e.g., Bluetooth, Wi-Fi, NFC, hard-wire,etc.) with devices that are reasonably co-located with the laryngoscope599. Alternatively, the laryngoscope 599 may be in indirectcommunication with other devices (e.g., hospital computer 528) throughintermediary communication components. For example, the laryngoscope 599may connect directly to the defibrillator/monitor 572, which then relayssignals to the hospital computer528.

In the embodiment illustrated in FIG. 5, it will be appreciated thatsignals (e.g., video or audio data) may be displayed directly on thelaryngoscope 599 as well as communicated to the other devices forsimultaneous display. In this example, the images being captured by thelaryngoscope 599 may be conveyed to, for instance, an EMS tablet 526 inuse by another medical technician on the scene. In yet anotheralternative, the images being captured may be conveyed from thelaryngoscope 599 through to the hospital computer 528 at which thoseimages may be reviewed by other medical personnel, such as doctors ornurses, who may be able to render real-time assistance from their remotelocation.

Similarly, one or more of the remote devices may include recordingmechanisms for recording all or a portion of the images being conveyedby the laryngoscope 599. These and other embodiments will becomeapparent to those skilled in the art from a careful study of thisdisclosure.

Enhancements to the Data Storage Process

A laryngoscope configured in accordance with the present disclosure mayfurther include logic to enhance or simplify the capture of relevantdata during a laryngoscopy while reducing irrelevant data. Morespecifically, it is envisioned that an operator of a video laryngoscopemay be in a stressful and difficult situation and may be occupied orpreoccupied with several tasks simultaneously. To that end, it may bedetrimental to the recording process if data streaming from the imagecapture module 860 are only recorded immediately upon activation of thegrip sensor 858. For instance, an operator of the laryngoscope 300 mayneed to remove his or her hand briefly or readjust his or her grip onthe laryngoscope 300 during operation. Embodiments of the disclosure maybe implemented to address this situation. Referring now to FIGS. 3 and4, the memory unit 830 of the laryngoscope 300 includes bothnon-volatile memory 410 and volatile memory 420. The volatile memory 420includes a buffer for temporarily storing data. As shown in FIG. 4,image data being captured by the image capture module 860 is written tothe volatile memory 420 and stored there temporarily for some amount oftime. The duration that image data is stored will depend on manyfactors, including the size of the volatile memory, the pixel density ofthe captured images, any compression applied to the data stream, and thelike. Accordingly, image data may be stored in the volatile memory 420for some time after it is captured. The length of time image data isstored by also be field-configurable by the operator, or perhapsadjustable by the manufacturer or a service representative.

Upon the grip sensor 858 detecting the operator's grip, rather than onlystoring image data from that moment forward, prior image data may alsobe stored to non-volatile memory 410 for later use. For instance, asillustrated in FIG. 4, the grip sensor 858 may detect the operator'sgrip at some time “T” 41. At that instant, the processor 820 may causeimage data from some configurable prior time (“T-N” 413) to be writtento non-volatile memory. By way of example, the operator may grip thelaryngoscope at a certain moment, thereby activating the grip sensor858. In response, image data from the prior 30 seconds (or any otherconfigurable time period) may be written from the volatile memory to thenon-volatile memory for later use. In this way, the likelihood thatrelevant data is lost is decreased. For instance, should the operatorrelease his or her grip on the laryngoscope briefly, but re-grip thelaryngoscope within the configurable time frame, no image data would belost.

In yet another enhancement, the laryngoscope 300 could be configured tocontinue writing image data to non-volatile memory 410 for some fixed orconfigurable interval of time after the grip sensor detects that thehandle is no longer being gripped. Such an enhancement would furtherameliorate the possibility of relevant data being lost due to brief ortemporary releases of the handle.

In still another enhancement, the amount of data stored from prior-tothe triggering handle-grip event, and/or after the sensor(s) detectsthat the handle is no longer being gripped, could be configured to bedifferent for video vs audio data, in a system where both types of dataare automatically recorded upon triggering from a handle-grip event. Forexample, audio data for an interval prior to and after the actuallaryngoscopy may provide value for capturing details about thepreparation for the procedure, and the confirmation of successfulcompletion of the procedure, whereas video data while the operator'shand is not holding the handle is likely of no explicit value.

Additional Alternative Embodiments

Certain additional embodiments may become apparent to those skilled inthe art based on the preceding disclosure. For example, one alternativeembodiment may be implemented in systems in which the amount of storagespace is not a constraint, yet identification of most-relevant image (oraudio) data remains desirable. In such an embodiment, image data may becaptured and stored to non-volatile memory for later use. In this way,the entirety of the image data stream may be available for lateranalysis. However, it continues to remain desirable to have easy andquick access to the most-relevant image (or audio) data recorded. Thus,the grip sensor 858 may be used to trigger the recording of atime-stamped event that is synchronized or embedded within the stream ofimage data. In this way, for example, a user may later quickly jump tothose events (e.g., intubation, extraction, etc.) within the fullrecorded data stream. Still further, the grip and release events couldbe used to configure timing of a report of 15 intubation that, inaddition to the audio or video recording, also includes physiologicdata, queried from a host monitor, from a period of time related to thetimes of grip and release (for example, 60 seconds before grip to 180seconds after release).

In still another alternative embodiment, a (non-video) laryngoscope maybe configured with an audio loop recorder, rather than an image capturedevice, that captures audio data for an interval related to the grip andrelease times. Such an alternative embodiment would be low-cost, yetcould be used in a system in which responders are trained to “talk tothe device” and provide verbal comments describing the event as itprogresses.

In yet another alternative embodiment, the grip sensor may beimplemented in a manner that not only recognizes the presence versusabsence of the operator's hand grip, but also measures the magnitude ofthe grip force/pressure, and/or the amount of handle surface area thatis being directly contacted by the operator's hand. Such quantitativemeasurements could then be recorded by the laryngoscope system, allowingenhanced review and analysis of these aspects of laryngoscopy technique.

In an extension of the above embodiment, a certain pattern of appliedgrip pressure/force—such as, for example, two squeezes in rapidsuccession akin to a double mouse click on a computer—could be used totrigger recording of a discrete snapshot image, separate from thecontinuous video file that may also be in the process of being recorded.Such an operator-triggered snapshot image capture capability would allowthe operator to capture a favorable or optimal image of interesting ornoteworthy airway anatomy or airway conditions, for purposes such asdocumentation, education, and quality improvement. One specific use ofsuch an operator-triggered snapshot image capture capability would be tofacilitate transfer or transmission of that image by the laryngoscopesystem (and/or a communicatively-coupled monitor-defibrillator system)into the patient care report, the patient's medical record, or a handoffreport, specifically to alert and illustrate to downstream careproviders specific airway features that may make the patient morechallenging to intubate. Such a “difficult airway handoff alert andillustration”, forwarded from a first care provider who has alreadynavigated a difficult airway, to a downstream care provider who mayotherwise be unaware of the specific challenges posed by the particularpatient's airway, would allow downstream care providers to make saferand more informed decisions about additional airway managementprocedures such as endotracheal tube exchange or extubation.

In yet another alternative embodiment, the grip sensor could beincorporated into a sleeve that fits over/around the handle of thelaryngoscope, rather than into the handle itself. Such a sleeve couldthen also be used on direct (non-video) laryngoscopes as well, whereinthe hand grip detected by the sensor could be used for theaforementioned tasks of initiating and terminating recording of audiodata, as well as recording specific event times associated with handlingof the laryngoscope.

In yet another alternative embodiment, the pressure or force sensorindicative of active use of the laryngoscope could be located elsewhereon the laryngoscope. For example, a pressure or force sensor could beincorporated into the laryngoscope blade, allowing detection of contactand lifting force applied the anterior structures of the airway. Suchpressure or force detection could then b e used to similarly controlvideo and/or audio recording as in the earlier-described embodiments.The magnitude of the pressure or force could also be measured andrecorded, which would be useful for analysis of laryngoscopy techniqueand correlation to physiologic responses to the laryngoscopy procedure.In a related embodiment, one or more pressure or force sensors could beincorporated into the rear base of the laryngoscope blade and/or handle,such that the sensors could detect force being applied to the patient'supper (maxillary) teeth, which might result in dental trauma. Detectionof such dental contact force could be used to trigger an alert or alarmnotifying the operator of the hazard.

In yet another alternative embodiment, one or more proximity sensors,pointed in one or more directions, could be located in or near the bladeof the laryngoscope. These sensors could be used to detect entry of theblade into a confined space such as the patient's mouth, or closeapproach of the blade-side of the handle to the patient's face.Detection of close proximity to the face or mouth while the videolaryngoscope is on could then be used to similarly control video and/oraudio recording as in the earlier-described embodiments.

Other embodiments may include combinations and sub-combinations offeatures described above or shown in the several figures, including forexample, embodiments that are equivalent to providing or applying afeature in a different order than in a described embodiment, extractingan individual feature from one embodiment and inserting such featureinto another embodiment; removing one or more features from anembodiment; or both removing one or more features from an embodiment andadding one or more features extracted from one or more otherembodiments, while providing the advantages of the features incorporatedin such combinations and sub-combinations. As used in this disclosure,“feature” or “features” can refer to structures and/or functions of anapparatus, article of manufacture or system, and/or the steps, acts, ormodalities of a method.

In the foregoing description, numerous details have been set forth inorder to provide a sufficient understanding of the describedembodiments. In other instances, well-known features have been omittedor simplified to not unnecessarily obscure the description.

A person skilled in the art in view of this description will be able topractice the disclosed invention. The specific embodiments disclosed andillustrated herein are not to be considered in a limiting sense. Indeed,it should be readily apparent to those skilled in the art that what isdescribed herein may be modified in numerous ways. Such ways can includeequivalents to what is described herein. In addition, the invention maybe practiced in combination with other systems. The following claimsdefine certain combinations and subcombinations of elements, features,steps, and/or functions, which are regarded as novel and non-obvious.Additional claims for other combinations and subcombinations may bepresented in this or a related document.

What is claimed is:
 1. A laryngoscope comprising: an image capturemodule configured to capture video as a data stream; a handle having asensor configured to detect that the handle is gripped by a hand; and aprocessor configured to embed a time-stamped event within the datastream based on the sensor detecting that the handle is gripped by thehand.
 2. The laryngoscope of claim 1, wherein the time-stamped eventcorresponds to a time of a grip of the handle, and wherein the processoris further configured to associate the video with physiologic dataobtained by a monitor-defibrillator during a period of time associatedwith the time of the grip.
 3. The laryngoscope of claim 2, wherein theperiod of time starts before the time of the grip.
 4. The laryngoscopeof claim 1, wherein the sensor is further configured to detect that thehandle is released by the hand, and wherein the processor is furtherconfigured to embed a second time-stamped event within the data streambased on the sensor detecting that the handle is released by the hand.5. The laryngoscope of claim 4, wherein the time-stamped eventcorresponds to a time of a grip of the handle, wherein the secondtime-stamped event corresponds to a time of a release of the handle, andwherein the processor is further configured to associate the video withphysiologic data obtained by a monitor-defibrillator during a period oftime associated with the time of the grip and the time of the release.6. The laryngoscope of claim 5, wherein the period of time starts beforethe time of the grip and ends after the time of the release.
 7. Thelaryngoscope of claim 1, wherein the processor is further configured tocause the video to be stored in memory.
 8. The laryngoscope of claim 1,wherein the sensor is further configured to detect a force applied tothe handle by the hand, and wherein the processor is further configuredto: determine that the handle is gripped with a pattern of applied forcebased on the sensor detecting the force applied to the handle; and causethe image capture module to capture an image and store the image inmemory based on determining that the handle is gripped with the patternof applied force.
 9. A method comprising: capturing video as a datastream by an image capture module of a laryngoscope; detecting, by asensor disposed in a handle of the laryngoscope, that the handle isgripped by a hand; and embedding, by a processor of the laryngoscope, atime-stamped event within the data stream based on the detecting, by thesensor, that the handle is gripped by the hand.
 10. The method of claim9, wherein the time-stamped event corresponds to a time of a grip of thehandle, and wherein the method further comprises associating, by theprocessor, the video with physiologic data obtained by amonitor-defibrillator during a period of time associated with the timeof the grip.
 11. The method of claim 9, further comprising: detecting,by the sensor, that the handle is no longer being gripped by the hand;and embedding, by the processor, a second time-stamped event within thedata stream based on the detecting, by the sensor, that the handle is nolonger being gripped by the hand.
 12. The method of claim 9, furthercomprising causing the video to be stored in memory.
 13. A laryngoscopecomprising: a blade; a camera integrated into the blade and configuredto capture a stream of image data; a handle having a sensor configuredto detect that the handle is gripped by a hand; and a processorconfigured to record a time-stamped event within the stream of imagedata based on the sensor detecting that the handle is gripped by thehand.
 14. The laryngoscope of claim 13, wherein the time-stamped eventcorresponds to a time of a grip of the handle, and wherein the processoris further configured to associate at least a portion of the stream ofimage data with physiologic data obtained by a monitor-defibrillatorduring a period of time associated with the time of the grip.
 15. Thelaryngoscope of claim 14, wherein the period of time starts before thetime of the grip.
 16. The laryngoscope of claim 13, wherein the sensoris further configured to detect that the handle is no longer beinggripped by the hand, and wherein the processor is further configured torecord a second time-stamped event within the stream of image data basedon the sensor detecting that the handle is no longer being gripped bythe hand.
 17. The laryngoscope of claim 16, wherein the time-stampedevent corresponds to a time of a grip of the handle, wherein the secondtime-stamped event corresponds to a time of a release of the handle, andwherein the processor is further configured to associate the video withphysiologic data obtained by a monitor-defibrillator during a period oftime associated with the time of the grip and the time of the release.18. The laryngoscope of claim 13, wherein the sensor is furtherconfigured to detect a pressure applied to the handle by the hand, andwherein the processor is further configured to: determine that thehandle is gripped with a pattern of applied pressure based on the sensordetecting the pressure applied to the handle; and cause the camera tocapture an image and store the image in memory based on determining thatthe handle is gripped with the pattern of applied pressure.
 19. Thelaryngoscope of claim 13, wherein the sensor is further configured todetect an amount of pressure with which the handle is gripped by thehand, and wherein the processor is further configured to cause theamount of pressure to be stored in memory.
 20. The laryngoscope of claim13, wherein the sensor is further configured to detect an amount of asurface area of the handle that is gripped by the hand, and wherein theprocessor is further configured to cause the amount of the surface areato be stored in memory.